The endometriosis daily diary: qualitative research to explore the patient experience of endometriosis and inform the development of a patient-reported outcome (PRO) for endometriosis-related pain

Purpose Endometriosis is a chronic disorder of the female reproductive system characterized by debilitating symptoms, particularly endometriosis-related pain (ERP). Patient-reported outcome (PRO) measures of symptoms and impacts are required to assess disease severity in ERP clinical studies and clinical practice. A content-valid instrument was developed by modifying the Dysmenorrhea Daily Diary (DysDD) to form the Endometriosis Daily Diary (EDD), an electronic PRO administered via handheld device. Methods Qualitative research with US females with ERP was conducted in three stages: (1) Development of an endometriosis conceptual model based on qualitative literature and conduct of concept elicitation (CE) interviews (N = 30). (2) Cognitive debriefing (CD) interviews (N = 30) conducted across two rounds to assess relevance and understanding of the EDD, with modifications between interview rounds. (3) Pilot testing to assess usability/feasibility of administrating the EDD daily on an electronic handheld device (N = 15). Clinical experts provided guidance throughout the study. Results The conceptual model provided a comprehensive summary of endometriosis to inform modifications to the DysDD, forming the EDD. CD results demonstrated that EDD items were relevant for most participants. Instructions, items, response scales, and recall period were well-understood. The resulting daily diary assesses severity of cyclic and non-cyclic pelvic pain, dyspareunia, impact of ERP on functioning and daily life, symptoms associated with ERP, and bowel symptoms. Participants were able to complete the diary daily and found the device easy to use. Conclusion The EDD demonstrated good content validity in females experiencing ERP. The next step is to perform psychometric validation in an ERP sample.

Decomposing variance in co-rumination using dyadic daily diary data

Co-rumination is the process of perseverating on problems, negative thoughts, or feelings with another person. Still unknown is how co-rumination unfolds within the daily lives of romantic couples. Using a variance decomposition procedure on data from a 14-day dyadic daily diary, we assess how much co-rumination varies over time and whether it is a couple- or individual-level process. Results revealed that within-person fluctuations in co-rumination contributed most (~33%) to the total variance and that these fluctuations could be reliably assessed using multi-item summary scores. Although time-invariant between-couple differences account significantly for the total variance (~14%) and can be reliably assessed, there is little within-couple agreement on the extent to which co-rumination fluctuates on a daily level. More research is needed to understand when and why perceptions of daily co-rumination diverge within couples, and how this informs theory on co-rumination and similar ostensibly dyadic constructs.

Exploring how exchange orientation affects conflict and intimacy in the daily life of romantic couples

We test the hypothesis that partners’ tendency to “keep score” in a relationship–as reflected in their exchange orientation–will moderate the effect of daily conflicts on their relationship evaluations. Cohabitating romantic partners (N = 82 couples) participated in a 28-day daily diary study. Partners higher in exchange orientation showed lower intimacy with their partner on days with conflict compared to days without conflict; the effect was attenuated for partners lower in exchange orientation. This result held even while adjusting for daily negative affect. We conclude that close monitoring of costs and benefits in a relationship, a characteristic of partners with high exchange orientation, may lead partners to overreact to simple daily conflicts, to the detriment of relationship evaluations.

Daily Financial Thoughts and Indices of Mental and Physical Health: The Importance of Socioeconomic Status

The current study examined the associations between daily financial thoughts, socioeconomic status (SES), and indices of emotional (positive and negative affect (PA/NA)) and physical health (physical symptoms and cortisol). Participants (N = 782) from the National Study of Daily Experiences, a subsample of the Midlife in the United States Refresher survey, completed daily diary interviews and provided saliva samples, from which cortisol was assayed. Participants who, on average, reported more daily financial thoughts also reported more NA, less PA, more physical symptoms, and had higher cortisol AUCg (all p’s < .05). These effects were more pronounced among people reporting lower SES. Daily fluctuations in financial thoughts also predicted daily fluctuations in NA, PA, and physical symptoms (all p’s <. 01). Again, these associations were more pronounced among people reporting lower SES. Results indicate that intrusive, daily financial thoughts may be one pathway explaining the link between SES and health outcomes.